Czy należy operować żylaki przed przeprowadzeniem operacji ortopedycznych w celu zmniejszenia ryzyka powikłań zatorowo-zakrzepowych? Punkt widzenia angiologa

• Authors: Krzysztof Aniukiewicz , Zbigniew Krasiński

Title variants

EN

Is it necessary to remove varicose veins prior to orthopaedic surgery to reduce the risk for thromboembolic complications? A vascular surgeon’s perspective

• Languages of publication: PL EN

Abstracts

PL

Operacje endoprotezoplastyki stawu biodrowego i kolanowego obarczone są dużą częstością powikłań zakrzepowo- -zatorowych, a za jeden z czynników ryzyka uważa się żylaki kończyn dolnych. Z różnych przyczyn nie u wszystkich chorych można usunąć żylaki przed zabiegiem ortopedycznym. W artykule autorzy starają się poddać analizie dostępne dane literaturowe dotyczące wpływu usunięcia żylaków kończyn dolnych lub konsekwencji ich nieoperowania w grupie chorych, u których występuje konieczność wykonania dużej operacji ortopedycznej. Obecnie nie ma opracowań, na podstawie których można by określić warunki leczenia operacyjnego żylaków kończyn dolnych przed artroplastyką stawu biodrowego czy kolanowego. Autorzy pojedynczych doniesień sugerują, że takie postępowanie lecznicze przed operacją ortopedyczną może być korzystne dla chorych i jednocześnie wskazują na potrzebę dalszych badań. Badacze podkreślają, że obecnie profilaktykę przeciwzakrzepową należy stosować według wskazań, w oparciu o ocenę ryzyka wystąpienia tego typu powikłań, np. na podstawie skali Capriniego, w której obecność żylaków odpowiada 1 punktowi.

EN

Hip and knee joint arthroplasty is associated with a high incidence of thromboembolic complications, with lower extremity varicose veins presumed as one of the risk factors. For a multitude of reasons, the removal of varicose veins in all patients prior to orthopaedic surgery is not achievable. This study analyses the available data regarding the impact of removing lower extremity varicose veins or failure to operate them in the group of patients requiring large-scale orthopaedic surgery. At present, there are no studies that could allow us to determine the exact conditions under which surgical management of lower extremity varicose veins prior to total hip or knee arthroplasty is necessary. Individual findings suggest that such treatment prior to orthopaedic surgery may be beneficial for patients, whilst indicating the need for further research. Researchers emphasise that at present antithrombotic prophylaxis should be applied in accordance with the existing recommendations, based on adequate risk assessment, e.g. according to the Caprini risk assessment model, where the presence of varicose veins is associated with a score of 1 point.

Keywords

EN

endoprotezoplastyka stawu biodrowego/kolanowego; żylaki kończyn dolnych; żylna choroba zakrzepowo-zatorowa

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Pediatria i Medycyna Rodzinna
• Year: 2017
• Volume: 13
• Issue: 2
• Pages: 186–193

Contributors

author

Krzysztof Aniukiewicz

• Oddział Chirurgii, Centrum Medyczne Gizińscy, Bydgoszcz, Polska

author

Zbigniew Krasiński

• Klinika Chirurgii Ogólnej i Naczyń, Uniwersytet Medyczny w Poznaniu, Poznań, Polska

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• Document Type: article